| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $173.86 | $179.05 | $215.59 | |
Cigna
| Facility | $239.92 | $239.92 | $239.92 | |
Cigna
| Professional | $1,005.60 | $1,005.60 | $1,005.60 | |
United
| Professional | $130.55 | $215.66 | $453.82 |